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Hand, foot and mouth disease Hand, foot, and mouth disease, (HFMD) sometimes known as Coxsackie virus, is a common viral illness particularly in children (this is not related to foot and mouth disease associated with cattle). Symptoms of HFMD may vary but usually it is characterized by fever, sores in the mouth, rash with blisters, a sore throat and a general feeling of un-wellness. One or two days after the fever begins, sores may develop in the mouth. A rash usually appears on the palms of the hands and soles of the feet and occasionally on the bottom or the nappy area. The rash can be flat or raised, and may also appear as blisters. The rash can resemble Chicken Pox, however in the case of HFMD the rash is not itchy and the sores are smaller and more yellow. Should children be excluded from their Early Childhood Education service? How is it spread? • As far as you can, clean all toys and surfaces with detergent, AND then disinfect by wiping with or soaking in 1:100 dilute bleach. (Disinfecting toys and general surfaces such as tables is a precaution for outbreaks, not a ‘normal’ procedure. When you don’t have an outbreak frequent washing with detergent is OK). 3 – 7 days after being infected by the infection symptoms may start to appear. Infection is spread from person to person by direct contact with the faeces of an infected person, nasal and throat discharges, saliva or fluid from blisters. The infection is most easily spread in the first week of the illness What is the treatment? There is no specific treatment for HFMD, although some medications may provide relief from fever, aches, or pain from the mouth ulcers. The child should remain at home if they are unwell, or if they have blisters in or around the mouth. This is particularly important for infants and toddlers who may dribble. The fluid inside the blisters is infectious and so children should return only when the blisters have dried. If there are only small numbers of blisters that can be covered the child may return to the centre. Suggested precautions • Be aware of hand washing hygiene following nappy changes, as bowel motions can be infectious for several weeks after the initial illness. • Encourage good hand washing procedures among all children and teachers. Public Health Advisors for Early Childhood Education Services provide support and advice on a range of illnesses including practical hygiene guidelines for special situations, letters for parents, and guidance and support for Supervisor decisions. We can be contacted at Regional Public Health on 04 570 9002.